Summary and Analysis

In a dramatic break from the policies of other drug treatment programs in the Bay Area, the Positive Directions Treatment, Recovery and Prevention Academy in San Francisco is run on an abstinence-only basis. The emphasis of this program is on teaching those in this academy how to build the skills that enable them to maintain that abstinence. Those skills include managing money, parenting and relationships.

The author of this City Journal article, Erica Sandberg, notes that all other city-sponsored facilities for those in recovery require the distribution of medication-assisted treatment drugs like methadone or buprenorphine, and that they also provide supplies needed for drug use, such as clean needles, pipes, lighters and other paraphernalia.

Those leading this program are strong advocates for abstinence and strong opponents of mere “harm reduction.” Cedric Akbar is quoted as saying, “All the free needles and Narcan, they haven’t helped one person get up off the ground. San Francisco wants you constantly dependent on the system. That’s not what we want.” Instead, the Academy teaches men to stand on their own feet, an approach that runs counter to current fashion.

It would be worthwhile to monitor this program and the success of their graduates. If successful, this model could provide an alternative to other communities that want to offer help that extends far beyond mere “harm reduction.”


Excerpted from City Journal

An uprising is taking place in San Francisco. In a city now known as much for its humanitarian crisis and social breakdown as for its steep hills and beautiful bridges, formerly incarcerated people, mostly black men, are refusing to be homeless, addicted, and unprepared for life and success.

On September 7, the Positive Directions Treatment, Recovery, and Prevention Academy, an alternative-sentencing program that serves up to 84 formerly incarcerated men, opened its doors. Program participants receive up to 30 months of transformational support in a structured residential setting, at no cost to them. Spearheaded by Steve Adami, director of the Adult Probation Department’s Reentry Division, and in partnership with Westside Community Services and Positive Direction Equals Change, the Academy works to help former prisoners live honorably and independently.